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Hyperlipidemia After Renal Transplantation: Natural History and Pathophysiology

D. C. CATTRAN, M.D.; G. STEINER, M.D.; D. R. WILSON, M.D.; and S. S. A. FENTON, M.D.
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This study was supported in part by the Ontario Heart Foundation.

Portions of this paper were presented at the 10th Annual Meeting of the American Society of Nephrology, Washington, D.C., November 1977.

▸Requests for reprints should be addressed to D. C. Cattran, M.D.; Room 3-215 (College Wing), Toronto General Hospital, 101 College Street; Toronto, Ont. M5G 1L7, Canada.

Toronto, Canada

© 1979 American College of PhysiciansAmerican College of Physicians

Ann Intern Med. 1979;91(4):554-559. doi:10.7326/0003-4819-91-4-554
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Twenty-five patients had their lipid profile monitored sequentially for up to 3 years post-transplant. All patients had good graft function throughout the study. Forty-four percent remained hypertriglyceridemic. The lipid level was not due to diet or excessive weight gain. Triglyceride turnover studies showed that overproduction was the predominant defect in patients receiving massive steroids to reverse rejection and in stable long-term recipients. Repeat metabolic investigations in the latter group, after changing to alternate-day, equal-dose steroid therapy showed improvement in both the absolute triglyceride concentration and the triglyceride production rate. The correlation observed between basal insulin level and triglyceride concentration suggests the drug may act through this hormone, stimulating hepatic triglyceride production. A change to alternate-day steroid therapy should be considered in post-transplant patients who are hyperlipemic while receiving minimal daily prednisone therapy.





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